Alfred Adler On homosexuality What is Alfred Adler known for? Adler's ideas regarding non-heterosexual sexuality and various social forms of deviance have long been controversial. What are his views on homosexuality? Adler had classified 'homosexuals' as falling among the "failures of life".
Does he think homosexuality has any relation to birth order?
Does Alfred Adler think homosexuality has any relation to birth order?
Adler's ideas regarding non-heterosexual sexuality and various social forms of deviance have long been controversial. Along with prostitution and criminality, Adler had classified 'homosexuals' as falling among the "failures of life". In 1917, he began his writings on homosexuality with a 52-page magazine, and sporadically published more thoughts throughout the rest of his life.  The Dutch psychologist Gerard J. M. van den Aardweg underlines how Alfred Adler came to his conclusions for, in 1917, Adler believed that he had established a connection between homosexuality and an inferiority complex towards one's own gender. This point of view differed from Freud's theory that homosexuality is rooted in narcissism or Jung's view of expressions of contrasexuality vis-a-vis the archetypes of the Anima and Animus.  There is evidence that Adler may have moved towards abandoning the hypothesis. Towards the end of Adler's life, in the mid-1930s, his opinion towards homosexuality began to shift. Elizabeth H. McDowell, a New York state family social worker recalls undertaking supervision with Adler on a young man who was "living in sin" with an older man in New York City. Adler asked her, "Is he happy, would you say?" "Oh yes," McDowell replied. Adler then stated, "Well, why don't we leave him alone."  According to Phyllis Bottome, who wrote Adler's Biography (after Adler himself laid upon her that task): "Homosexuality he always treated as lack of courage. These were but ways of obtaining a slight release for a physical need while avoiding a greater obligation. A transient partner of your own sex is a better known road and requires less courage than a permanent contact with an "unknown" sex. [...] Adler taught that men cannot be judged from within by their "possessions," as he used to call nerves, glands, traumas, drives et cetera, since both judge and prisoner are liable to misconstrue what is invisible and incalculable; but that he can be judged, with no danger from introspection, by how he measures up to the three common life tasks set before every human being between the cradle and the grave. Work or employment, love or marriage, social contact." CANNOTANSWER
CANNOTANSWER
Alfred Adler (; ; 7 February 1870 – 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of inferiority, the inferiority complex, is recognized as an isolating element which plays a key role in personality development. Alfred Adler considered a human being as an individual whole, and therefore he called his psychology "Individual Psychology" (Orgler 1976).

Adler was the first to emphasize the importance of the social element in the re-adjustment process of the individual and to carry psychiatry into the community. A Review of General Psychology survey, published in 2002, ranked Adler as the 67th most eminent psychologist of the 20th century.

Early life
Alfred Adler was born on February 7, 1870 at Mariahilfer Straße 208 in Rudolfsheim, a village on the western fringes of Vienna, a modern part of Rudolfsheim-Fünfhaus, the 15th district of the city. He was second of the seven children of a Jewish couple, Pauline (Beer) and Leopold Adler. Leopold Adler was a Hungarian-born grain merchant. Alfred's younger brother died in the bed next to him when Alfred was only three years old, and throughout his childhood, he maintained a rivalry with his older brother. This rivalry was spurred on because Adler believed his mother preferred his brother over him. Despite his good relationship with his father, he still struggled with feelings of inferiority in his relationship with his mother.

Alfred was an active, popular child and an average student who was also known for the competitive attitude toward his older brother, Sigmund. Early on, he developed rickets, which kept Alfred from walking until he was four years old. At the age of four, he developed pneumonia and heard a doctor say to his father, "Your boy is lost". Along with being run over twice and witnessing his younger brother's death, this sickness contributed to his overall fear of death. At that point, he decided to be a physician. He was very interested in the subjects of psychology, sociology and philosophy. After studying at University of Vienna, he specialized as an eye doctor, and later in neurology and psychiatry.

Career
Adler began his medical career as an ophthalmologist, but he soon switched to general practice, and established his office in a less affluent part of Vienna across from the Prater, a combination of amusement park and circus. His clients included circus people, and it has been suggested that the unusual strengths and weaknesses of the performers led to his insights into "organ inferiorities" and "compensation".

In his early career, Adler wrote an article in the defense of Freud's theory after reading one of Freud's most well known works, The Interpretation of Dreams. In 1902, because of his defense article, Adler received an invitation from Sigmund Freud to join an informal discussion group that included Rudolf Reitler and Wilhelm Stekel. The group, the "Wednesday Society" (Mittwochsgesellschaft), met regularly on Wednesday evenings at Freud's home and was the beginning of the psychoanalytic movement, expanding over time to include many more members. Each week a member would present a paper and after a short break of coffee and cakes, the group would discuss it.  The main members were Otto Rank, Max Eitingon, Wilhelm Stekel, Karl Abraham, Hanns Sachs, Fritz Wittels, Max Graf, and Sandor Ferenczi.  In 1908, Adler presented his paper, "The aggressive instinct in life and in neurosis", at a time when Freud believed that early sexual development was the primary determinant of the making of character, with which Adler took issue.  Adler proposed that the sexual and aggressive drives were "two originally separate instincts which merge later on".  Freud at the time disagreed with this idea.

When Freud in 1920 proposed his dual instinct theory of libido and aggressive drives in Beyond the Pleasure Principle, without citing Adler, he was reproached that Adler had proposed the aggressive drive in his 1908 paper (Eissler, 1971). Freud later commented in a 1923 footnote he added to the Little Hans case that, "I have myself been obliged to assert the existence of an aggressive instinct" (1909, p. 140, 2), while pointing out that his conception of an aggressive drive differs from that of Adler.  A long-serving member of the group, he made many more beyond this 1908 pivotal contribution to the group, and Adler became president of the Vienna Psychoanalytic Society eight years later (1910). He remained a member of the Society until 1911, when he and a group of his supporters formally disengaged from Freud's circle, the first of the great dissenters from orthodox psychoanalysis (preceding Carl Jung's split in 1914).

This departure suited both Freud and Adler, since they had grown to dislike each other. During his association with Freud, Adler frequently maintained his own ideas which often diverged from Freud's. While Adler is often referred to as "a pupil of Freud", in fact this was never true; they were colleagues, Freud referring to him in print in 1909 as "My colleague Dr Alfred Adler". The association of Adler and Freud lasted a total of 9 years, and they never saw each other after the separation. Freud continued to dislike Adler even after the separation and tended to do so with other defectors from psychoanalysis. Even after Adler's death, Freud maintained his distaste for him. When conversing with a colleague over the matter, he stated, "I don't understand your sympathy for Adler. For a Jewish boy out of a Viennese suburb a death in Aberdeen is an unheard of career in itself and a proof of how far he had got on. The world really rewarded him richly for his service in having contradicted psychoanalysis." In 1929 Adler showed a reporter with the New York Herald a copy of the faded postcard that Freud had sent him in 1902. He wanted to prove that he had never been a disciple of Freud's but rather that Freud had sought him out to share his ideas. 

Adler founded the Society for Individual Psychology in 1912 after his break from the psychoanalytic movement. Adler's group initially included some orthodox Nietzschean adherents (who believed that Adler's ideas on power and inferiority were closer to Nietzsche than Freud's). Their enmity aside, Adler retained a lifelong admiration for Freud's ideas on dreams and credited him with creating a scientific approach to their clinical utilization (Fiebert, 1997). Nevertheless, even regarding dream interpretation, Adler had his own theoretical and clinical approach. The primary differences between Adler and Freud centered on Adler's contention that the social realm (exteriority) is as important to psychology as is the internal realm (interiority). The dynamics of power and compensation extend beyond sexuality, and gender and politics can be as important as libido. Moreover, Freud did not share Adler's socialist beliefs, the latter's wife being for example an intimate friend of many of the Russian Marxists such as Leon Trotsky.

The Adlerian school 
Following Adler's break from Freud, he enjoyed considerable success and celebrity in building an independent school of psychotherapy and a unique personality theory. He traveled and lectured for a period of 25 years promoting his socially oriented approach. His intent was to build a movement that would rival, even supplant, others in psychology by arguing for the holistic integrity of psychological well-being with that of social equality. Adler's efforts were halted by World War I, during which he served as a doctor with the Austro-Hungarian Army. After the conclusion of the war, his influence increased greatly. In the 1920s, he established a number of child guidance clinics. From 1921 onwards, he was a frequent lecturer in Europe and the United States, becoming a visiting professor at Columbia University in 1927. His clinical treatment methods for adults were aimed at uncovering the hidden purpose of symptoms using the therapeutic functions of insight and meaning.

Adler was concerned with the overcoming of the superiority/inferiority dynamic and was one of the first psychotherapists to discard the analytic couch in favor of two chairs. This allows the clinician and patient to sit together more or less as equals. Clinically, Adler's methods are not limited to treatment after-the-fact but extend to the realm of prevention by preempting future problems in the child. Prevention strategies include encouraging and promoting social interest, belonging, and a cultural shift within families and communities that leads to the eradication of pampering and neglect (especially corporal punishment). Adler's popularity was related to the comparative optimism and comprehensibility of his ideas. He often wrote for the lay public. Adler always retained a pragmatic approach that was task-oriented. These "Life tasks" are occupation/work, society/friendship, and love/sexuality. Their success depends on cooperation. The tasks of life are not to be considered in isolation since, as Adler famously commented, "they all throw cross-lights on one another".

In his bestselling book, Man's Search for Meaning, Dr. Viktor E. Frankl compared his own "Third Viennese School of Psychotherapy" (after Freud's and Adler's schools) to Adler's analysis:

Emigration 
In the early 1930s, after most of Adler's Austrian clinics had been closed due to his Jewish heritage (despite his conversion to Christianity), Adler left Austria for a professorship at the Long Island College of Medicine in the US. Adler died from a heart attack in 1937 in Aberdeen, Scotland, during a lecture tour, although his remains went missing and were unaccounted for until 2007.  His death was a temporary blow to the influence of his ideas, although a number of them were subsequently taken up by neo-Freudians. Through the work of Rudolf Dreikurs in the United States and many other adherents worldwide, Adlerian ideas and approaches remain strong and viable more than 70 years after Adler's death.

Around the world there are various organizations promoting Adler's orientation towards mental and social well-being. These include the International Committee of Adlerian Summer Schools and Institutes (ICASSI), the North American Society of Adlerian Psychology (NASAP) and the International Association for Individual Psychology. Teaching institutes and programs exist in Austria, Canada, England, Germany, Greece, Israel, Italy, Japan, Latvia, Switzerland, the United States, Jamaica, Peru, and Wales.

Basic principles 
Adler was influenced by the mental construct ideas of the philosopher Hans Vaihinger (The Philosophy of 'As if') and the literature of Dostoyevsky. While still a member of the Vienna Psychoanalytic Society he developed a theory of organic inferiority and compensation that was the prototype for his later turn to phenomenology and the development of his famous concept, the inferiority complex.

Adler was also influenced by the philosophies of Immanuel Kant, Friedrich Nietzsche, Rudolf Virchow and the statesman Jan Smuts (who coined the term "holism"). Adler's School, known as "Individual Psychology"—an arcane reference to the Latin individuals meaning indivisibility, a term intended to emphasize holism—is both a social and community psychology as well as a depth psychology. Adler was an early advocate in psychology for prevention and emphasized the training of parents, teachers, social workers and so on in democratic approaches that allow a child to exercise their power through reasoned decision making whilst co-operating with others. He was a social idealist, and was known as a socialist in his early years of association with psychoanalysis (1902–1911).

Adler was pragmatic and believed that lay people could make practical use of the insights of psychology. Adler was also an early supporter of feminism in psychology and the social world, believing that feelings of superiority and inferiority were often gendered and expressed symptomatically in characteristic masculine and feminine styles. These styles could form the basis of psychic compensation and lead to mental health difficulties. Adler also spoke of "safeguarding tendencies" and neurotic behavior long before Anna Freud wrote about the same phenomena in her book The Ego and the Mechanisms of Defense.

Adlerian-based scholarly, clinical and social practices focus on the following topics:
 Social interest and community feeling
 Holism and the creative self
 Fictional finalism, teleology, and goal constructs
 Psychological and social encouragement
 Inferiority, superiority and compensation
 Life style/style of life
 Early recollections (a projective technique)
 Family constellation and birth order
 Life tasks and social embeddedness
 The conscious and unconscious realms
 Private logic and common sense (based in part on Kant's "")
 Symptoms and neurosis
 Safeguarding behavior
 Guilt and guilt feelings
 Socratic questioning
 Dream interpretation
 Child and adolescent psychology
 Democratic approaches to parenting and families
 Adlerian approaches to classroom management
 Leadership and organizational psychology

Adler created Adlerian Therapy, because he believed that one's psyche should be studied in the context of that person's environment.

Adler's approach to personality 
In one of his earliest and most famous publications, "Study of Organ Inferiority and Its Physical Compensation," Adler outlined the basics for what would be the beginning foundation of his personality theory. The article focuses mainly on the topics of organ inferiority and compensation. Organ inferiority is when one organ, or portion of the body, is weaker than the rest. Adler postulated that the body's other organs would work together in order to compensate for the weakness of this "inferior" organ. When compensation occurs, other areas of the body make up for the function lacking in the inferior portion. In some cases, the weakness may be overcompensated transforming it into a strength. An example would be an individual with a weak leg becoming a great runner later on. As his theory progressed, the idea of organ inferiority was replaced with feelings of inferiority instead. As Adler's theory progressed, he continued evolving his theory and key ideas.

Adler's book, Über den nervösen Charakter (The Neurotic Character) defines his earlier key ideas. He argued that human personality could be explained teleologically: parts of the individual's unconscious self ideally work to convert feelings of inferiority to superiority (or rather completeness). The desires of the self ideal were countered by social and ethical demands. If the corrective factors were disregarded and the individual overcompensated, then an inferiority complex would occur, fostering the danger of the individual becoming egocentric, power-hungry and aggressive or worse.

Common therapeutic tools include the use of humor, historical instances, and paradoxical injunctions.

Psychodynamics and teleology 
Adler maintained that human psychology is psychodynamic in nature. Unlike Freud's metapsychology that emphasizes instinctual demands, human psychology is guided by goals and fueled by a yet unknown creative force. Like Freud's instincts, Adler's fictive goals are largely unconscious. These goals have a "teleological" function. Constructivist Adlerians, influenced by neo-Kantian and Nietzschean ideas, view these "teleological" goals as "fictions" in the sense that Hans Vaihinger spoke of (fictio). Usually there is a fictional final goal which can be deciphered alongside of innumerable sub-goals. The inferiority/superiority dynamic is constantly at work through various forms of compensation and overcompensation. For example, in anorexia nervosa the fictive final goal is to "be perfectly thin" (overcompensation on the basis of a feeling of inferiority). Hence, the fictive final goal can serve a persecutory function that is ever-present in subjectivity (though its trace springs are usually unconscious). The end goal of being "thin" is fictive however since it can never be subjectively achieved.

Teleology serves another vital function for Adlerians. Chilon's "hora telos" ("see the end, consider the consequences") provides for both healthy and maladaptive psychodynamics. Here we also find Adler's emphasis on personal responsibility in mentally healthy subjects who seek their own and the social good.

Constructivism and metaphysics 
The metaphysical thread of Adlerian theory does not problematize the notion of teleology since concepts such as eternity (an ungraspable end where time ceases to exist) match the religious aspects that are held in tandem. In contrast, the constructivist Adlerian threads (either humanist/modernist or postmodern in variant) seek to raise insight of the force of unconscious fictions– which carry all of the inevitability of 'fate'– so long as one does not understand them. Here, 'teleology' itself is fictive yet experienced as quite real. This aspect of Adler's theory is somewhat analogous to the principles developed in Rational Emotive Behavior Therapy (REBT) and Cognitive Therapy (CT). Both Albert Ellis and Aaron T. Beck credit Adler as a major precursor to REBT and CT. Ellis in particular was a member of the North American Society for Adlerian Psychology and served as an editorial board member for the Adlerian Journal Individual Psychology.

As a psychodynamic system, Adlerians excavate the past of a client/patient in order to alter their future and increase integration into community in the 'here-and-now'. The 'here-and-now' aspects are especially relevant to those Adlerians who emphasize humanism and/or existentialism in their approaches.

Holism 
Metaphysical Adlerians emphasize a spiritual holism in keeping with what Jan Smuts articulated (Smuts coined the term "holism"), that is, the spiritual sense of one-ness that holism usually implies (etymology of holism: from ὅλος holos, a Greek word meaning all, entire, total)  Smuts believed that evolution involves a progressive series of lesser wholes integrating into larger ones. Whilst Smuts' text Holism and Evolution is thought to be a work of science, it actually attempts to unify evolution with a higher metaphysical principle (holism). The sense of connection and one-ness revered in various religious traditions (among these, Christianity, Judaism, Zoroastrianism, Islam, Buddhism and Baha'i) finds a strong complement in Adler's thought.

The pragmatic and materialist aspects to contextualizing members of communities, the construction of communities and the socio-historical-political forces that shape communities matter a great deal when it comes to understanding an individual's psychological make-up and functioning. This aspect of Adlerian psychology holds a high level of synergy with the field of community psychology, especially given Adler's concern for what he called "the absolute truth and logic of communal life". However, Adlerian psychology, unlike community psychology, is holistically concerned with both prevention and clinical treatment after-the-fact. Hence, Adler can be considered the "first community psychologist", a discourse that formalized in the decades following Adler's death (King & Shelley, 2008).

Adlerian psychology, Carl Jung's analytical psychology, Gestalt therapy and Karen Horney's psychodynamic approach are holistic schools of psychology. These discourses eschew a reductive approach to understanding human psychology and psychopathology.

Typology 
Adler developed a scheme of so-called personality types, which were however always to be taken as provisional or heuristic since he did not, in essence, believe in personality types, and at different times proposed different and equally tentative systems. The danger with typology is to lose sight of the individual's uniqueness and to gaze reductively, acts that Adler opposed. Nevertheless, he intended to illustrate patterns that could denote a characteristic governed under the overall style of life. Hence American Adlerians such as Harold Mosak have made use of Adler's typology in this provisional sense:
 The Getting or Leaning They are sensitive people who have developed a shell around themselves which protects them, but they must rely on others to carry them through life's difficulties. They have low energy levels and so become dependent. When overwhelmed, they develop what we typically think of as neurotic symptoms: phobias, obsessions and compulsions, general anxiety, hysteria, amnesias, and so on, depending on individual details of their lifestyle.
 The Avoiding types are those that hate being defeated. They may be successful, but have not taken any risks getting there. They are likely to have low social contact in fear of rejection or defeat in any way.
 The Ruling or Dominant type strive for power and are willing to manipulate situations and people, anything to get their way. People of this type are also prone to anti-social behavior.
 The Socially Useful types are those who are very outgoing and very active. They have a lot of social contact and strive to make changes for the good.

These 'types' are typically formed in childhood and are expressions of the Style of Life.

The importance of memories 
Adler placed great emphasis upon the interpretation of early memories in working with patients and school children, writing that, "Among all psychic expressions, some of the most revealing are the individual's memories." Adler viewed memories as expressions of "private logic" and as metaphors for an individual's personal philosophy of life or "lifestyle". He maintained that memories are never incidental or trivial; rather, they are chosen reminders: "(A person's) memories are the reminders she carries about with her of her limitations and of the meanings of events. There are no 'chance' memories. Out of the incalculable number of impressions that an individual receives, she chooses to remember only those which she considers, however dimly, to have a bearing on her problems."

On birth order 
Adler often emphasized one's psychological birth order as having an influence on the style of life and the strengths and weaknesses in one's psychological make up. Birth order referred to the placement of siblings within the family. It is important to note the difference between psychological and ordinal birth order (e.g. in some families, a second child might behave like a firstborn, in which case they are considered to be an ordinal secondborn but a psychological firstborn). Mosak, H.H. & Maniacci, M. P. (1999). A primer of Adlerian Psychology. Taylor and Francis. Adler believed that the firstborn child would be in a favorable position, enjoying the full attention of the eager new parents until the arrival of a second child. This second child would cause the first born to suffer feelings of dethronement, no longer being the center of attention. Adler (1908) believed that in a three-child family, the oldest child would be the most likely to suffer from neuroticism and substance addiction which he reasoned was a compensation for the feelings of excessive responsibility "the weight of the world on one's shoulders" (e.g. having to look after the younger ones) and the melancholic loss of that once supremely pampered position. As a result, he predicted that this child was the most likely to end up in jail or an asylum. Youngest children would tend to be overindulged, leading to poor social empathy. Consequently, the middle child, who would experience neither dethronement nor overindulgence, was most likely to develop into a successful individual yet also most likely to be a rebel and to feel squeezed-out. Adler himself was the third (some sources credit second) in a family of six children.

Adler never produced any scientific support for his interpretations on birth order roles, nor did he feel the need to. Yet the value of the hypothesis was to extend the importance of siblings in marking the psychology of the individual beyond Freud's more limited emphasis on the mother and father. Hence, Adlerians spend time therapeutically mapping the influence that siblings (or lack thereof) had on the psychology of their clients. The idiographic approach entails an excavation of the phenomenology of one's birth order position for likely influence on the subject's Style of Life. In sum, the subjective experiences of sibling positionality and inter-relations are important in terms of the dynamics of psychology, for Adlerian therapists and personality theorists, not the cookbook predictions that may or may not have been objectively true in Adler's time.

For Adler, birth order answered the question, "Why do children, who are raised in the same family, grow up with very different personalities?"  While a strict geneticist, believing siblings are raised in a shared environment, may claim any differences in personality would be caused by subtle variations in the individuals' genetics,  Adler showed through his birth order theory that children do not grow up in the same shared environment, but the oldest child grows up in a family where they have younger siblings, the middle child with older and younger siblings, and the youngest with older siblings. The position in the family constellation, Adler said, is the reason for these differences in personality and not genetics: a point later taken up by Eric Berne.

On addiction 
Adler's insight into birth order, compensation and issues relating to the individuals' perception of community also led him to investigate the causes and treatment of substance abuse disorders, particularly alcoholism and morphinism, which already were serious social problems of his time. Adler's work with addicts was significant since most other prominent proponents of psychoanalysis invested relatively little time and thought into this widespread ill of the modern and post-modern age. In addition to applying his individual psychology approach of organ inferiority, for example, to the onset and causes of addictive behaviors, he also tried to find a clear relationship of drug cravings to sexual gratification or their substitutions. Early pharmaco-therapeutic interventions with non-addictive substances, such as neuphyllin were used, since withdrawal symptoms were explained by a form of "water-poisoning" that made the use of diuretics necessary.

Adler and his wife's pragmatic approach, and the seemingly high success rates of their treatment were based on their ideas of social functioning and well-being. Clearly, life style choices and situations were emphasized, for example the need for relaxation or the negative effects of early childhood conflicts were examined, which compared to other authoritarian or religious treatment regimens, were clearly modern approaches. Certainly some of his observations, for example that psychopaths were more likely to be drug addicts are not compatible with current methodologies and theories of substance abuse treatment, but the self-centered attributes of the illness and the clear escapism from social responsibilities by pathological addicts put Adler's treatment modalities clearly into a modern contextual reasoning.

On homosexuality 

Adler's ideas regarding non-heterosexual sexuality and various social forms of deviance have long been controversial. Along with prostitution and criminality, Adler had classified 'homosexuals' as falling among the "failures of life". In 1917, he began his writings on homosexuality with a 52-page magazine, and sporadically published more thoughts throughout the rest of his life.

The Dutch psychologist Gerard J. M. van den Aardweg underlines how Alfred Adler came to his conclusions for, in 1917, Adler believed that he had established a connection between homosexuality and an inferiority complex towards one's own gender. This point of view differed from Freud's theory that homosexuality is rooted in narcissism or Jung's view of expressions of contrasexuality vis-à-vis the archetypes of the Anima and Animus.

There is evidence that Adler may have moved towards abandoning the hypothesis. Towards the end of Adler's life, in the mid-1930s, his opinion towards homosexuality began to shift. Elizabeth H. McDowell, a New York state family social worker recalls undertaking supervision with Adler on a young man who was "living in sin" with an older man in New York City. Adler asked her, "Is he happy, would you say?" "Oh yes," McDowell replied. Adler then stated, "Well, why don't we leave him alone."

According to Phyllis Bottome, who wrote Adler's Biography (after Adler himself laid upon her that task): "He always treated homosexuality as lack of courage. These were but ways of obtaining a slight release for a physical need while avoiding a greater obligation. A transient partner of your own sex is a better known road and requires less courage than a permanent contact with an "unknown" sex.... Adler taught that men cannot be judged from within by their "possessions," as he used to call nerves, glands, traumas, drives et cetera, since both judge and prisoner are liable to misconstrue what is invisible and incalculable; but that he can be judged, with no danger from introspection, by how he measures up to the three common life tasks set before every human being between the cradle and the grave: work (employment), love or marriage (intimacy), and social contact (friendships.)"

Parent education 
Adler emphasized both treatment and prevention. With regard to psychodynamic psychology, Adlerians emphasize the foundational importance of childhood in developing personality and any tendency towards various forms of psychopathology. The best way to inoculate against what are now termed "personality disorders" (what Adler had called the "neurotic character"), or a tendency to various neurotic conditions (depression, anxiety, etc.), is to train a child to be and feel an equal part of the family. The responsibility of the optimal development of the child is not limited to the mother or father, but rather includes teachers and society more broadly. Adler argued therefore that teachers, nurses, social workers, and so on require training in parent education to complement the work of the family in fostering a democratic character. When a child does not feel equal and is enacted upon (abused through pampering or neglect) he or she is likely to develop inferiority or superiority complexes and various concomitant compensation strategies. These strategies exact a social toll by seeding higher divorce rates, the breakdown of the family, criminal tendencies, and subjective suffering in the various guises of psychopathology. Adlerians have long promoted parent education groups, especially those influenced by the famous Austrian/American Adlerian Rudolf Dreikurs (Dreikurs & Soltz, 1964).

Spirituality, ecology and community 
In a late work, Social Interest: A Challenge to Mankind (1938), Adler turns to the subject of metaphysics, where he integrates Jan Smuts' evolutionary holism with the ideas of teleology and community: "sub specie aeternitatis". Unabashedly, he argues his vision of society: "Social feeling means above all a struggle for a communal form that must be thought of as eternally applicable... when humanity has attained its goal of perfection... an ideal society amongst all mankind, the ultimate fulfillment of evolution." Adler follows this pronouncement with a defense of metaphysics:

This social feeling for Adler is Gemeinschaftsgefühl, a community feeling whereby one feels he or she belongs with others and has also developed an ecological connection with nature (plants, animals, the crust of this earth) and the cosmos as a whole, sub specie aeternitatis. Clearly, Adler himself had little problem with adopting a metaphysical and spiritual point of view to support his theories.

Death and cremation 
Adler died suddenly in Aberdeen, Scotland, in May 1937, during a three-week visit to the University of Aberdeen. While walking down the street, he was seen to collapse and lie motionless on the pavement. As a man ran over to him and loosened his collar, Adler mumbled "Kurt", the name of his son and died. The autopsy performed determined his death was caused by a degeneration of the heart muscle. His body was cremated at Warriston Crematorium in Edinburgh but the ashes were never reclaimed. In 2007, his ashes were rediscovered in a casket at Warriston Crematorium and returned to Vienna for burial in 2011.

Use of Adler's work without attribution
Much of Adler's theories have been absorbed into modern psychology without attribution. Psychohistorian Henri F. Ellenberger writes, "It would not be easy to find another author from which so much has been borrowed on all sides without acknowledgement than Alfred Adler." Ellenberger posits several theories for "the discrepancy between greatness of achievement, massive rejection of person and work, and wide-scale, quiet plagiarism..." These include Adler's "imperfect" style of writing and demeanor, his "capacity to create a new obviousness," and his lack of a large and well organized following.

Influence on depth psychology
In collaboration with Sigmund Freud and a small group of Freud's colleagues, Adler was among the co-founders of the psychoanalytic movement and a core member of the Vienna Psychoanalytic Society: indeed, to Freud he was "the only personality there". He was the first major figure to break away from psychoanalysis to form an independent school of psychotherapy and personality theory, which he called individual psychology because he believed a human to be an indivisible whole, an individuum. He also imagined a person to be connected or associated with the surrounding world.

This was after Freud declared Adler's ideas as too contrary, leading to an ultimatum to all members of the Society (which Freud had shepherded) to drop Adler or be expelled, disavowing the right to dissent (Makari, 2008). Nevertheless, Freud always took Adler's ideas seriously, calling them "honorable errors". Though one rejects the content of Adler's views, one can recognize their consistency and significance." Following this split, Adler would come to have an enormous, independent effect on the disciplines of counseling and psychotherapy as they developed over the course of the 20th century (Ellenberger, 1970). He influenced notable figures in subsequent schools of psychotherapy such as Rollo May, Viktor Frankl, Abraham Maslow and Albert Ellis. His writings preceded, and were at times surprisingly consistent with, later Neo-Freudian insights such as those evidenced in the works of Otto Rank, Karen Horney, Harry Stack Sullivan and Erich Fromm, some considering that it would take several decades for Freudian ego psychology to catch up with Adler's ground-breaking approach.

Adler emphasized the importance of equality in preventing various forms of psychopathology, and espoused the development of social interest and democratic family structures for raising children. His most famous concept is the inferiority complex which speaks to the problem of self-esteem and its negative effects on human health (e.g. sometimes producing a paradoxical superiority striving). His emphasis on power dynamics is rooted in the philosophy of Nietzsche, whose works were published a few decades before Adler's. Specifically, Adler's conceptualization of the "Will to Power" focuses on the individual's creative power to change for the better. Adler argued for holism, viewing the individual holistically rather than reductively, the latter being the dominant lens for viewing human psychology.  Adler was also among the first in psychology to argue in favor of feminism, and the female analyst, making the case that power dynamics between men and women (and associations with masculinity and femininity) are crucial to understanding human psychology (Connell, 1995). Adler is considered, along with Freud and Jung, to be one of the three founding figures of depth psychology, which emphasizes the unconscious and psychodynamics (Ellenberger, 1970; Ehrenwald, 1991); and thus to be one of the three great psychologists/philosophers of the twentieth century.

Personal life 
During his college years, he had become attached to a group of socialist students, among which he had found his wife-to-be, Raissa Timofeyewna Epstein, an intellectual and social activist from Russia studying in Vienna. Because Raissa was a militant socialist, she had a large impact on Adler's early publications and ultimately his theory of personality. They married in 1897 and had four children, two of whom, his daughter Alexandra and his son Kurt, became psychiatrists. Their children were writer, psychiatrist and Socialist activist Alexandra Adler; psychiatrist Kurt Adler; writer and activist Valentine Adler; and Cornelia "Nelly" Adler. Raissa, Adler's wife, died at 89 in New York City on April 21,1962. 

Author and journalist Margot Adler (1946-2014) was Adler's granddaughter.

Artistic and cultural references 
The two main characters in the novel Plant Teacher engage in a session of Adlerian lifestyle interpretation, including early memory interpretation.

In the episode Something About Dr. Mary of the television series Frasier, Frasier recalls having to "pass under a dangerously unbalanced portrait of Alfred Adler" during his studies at Harvard.

He appears as a character in the Young Indiana Jones chronicles.

English-language Adlerian journals 
 North America
 The Journal of Individual Psychology (University of Texas Press)
 The Canadian Journal of Adlerian Psychology (Adlerian Psychology Association of British Columbia)
 United Kingdom
 Adlerian Yearbook (Adlerian Society, UK)

Publications 
Alfred Adler's key publications were The Practice and Theory of Individual Psychology (1927), Understanding Human Nature (1927), & What Life Could Mean to You (1931). Other important publications are The Pattern of Life (1930), The Science of Living (1930), The Neurotic Constitution (1917), The Problems of Neurosis (1930). In his lifetime, Adler published more than 300 books and articles.

The Alfred Adler Institute of Northwestern Washington has recently published a twelve-volume set of The Collected Clinical Works of Alfred Adler, covering his writings from 1898–1937. An entirely new translation of Adler's magnum opus, The Neurotic Character, is featured in Volume 1. Volume 12 provides comprehensive overviews of Adler's mature theory and contemporary Adlerian practice.
 Volume 1 :  The Neurotic Character — 1907
 Volume 2 :  Journal Articles 1898–1909
 Volume 3 :  Journal Articles 1910–1913
 Volume 4 :  Journal Articles 1914–1920
 Volume 5 :  Journal Articles 1921–1926
 Volume 6 :  Journal Articles 1927–1931
 Volume 7 :  Journal Articles 1931–1937
 Volume 8 :  Lectures to Physicians & Medical Students
 Volume 9 :  Case Histories
 Volume 10 :  Case Readings & Demonstrations
 Volume 11 :  Education for Prevention
 Volume 12 :  The General System of Individual Psychology

Other key Adlerian texts 
 Adler, A. (1964). The Individual Psychology of Alfred Adler. H. L. Ansbacher and R. R. Ansbacher (Eds.). New York: Harper Torchbooks. .
 Adler, A. (1979). Superiority and Social Interest: A Collection of Later Writings. H. L. Ansbacher and R. R. Ansbacher (Eds.). New York, NY:  W. W. Norton. .

See also 
 Adlerian
 Classical Adlerian psychology
 Neo-Adlerian

Notes

References 
 Adler, A. (1908). Der Aggressionstrieb im Leben und der Neurose. Fortsch. Med.  26: 577–584.
Adler, A. (1938). Social Interest: A Challenge to Mankind. J. Linton and R. Vaughan (Trans.). London: Faber and Faber Ltd.
 Adler, A. (1956). The Individual Psychology of Alfred Adler. H. L. Ansbacher and R. R. Ansbacher (Eds.). New York: Harper Torchbooks.
 Connell, R. W. (1995). Masculinities. Cambridge, UK: Polity Press.
 Dreikurs, R. & Soltz, V. (1964). Children the Challenge. New York: Hawthorn Books.
 Ehrenwald, J. (1991, 1976). The History of Psychotherapy: From healing magic to encounter. Northvale, NJ: Jason Aronson Inc. 
Eissler, K.R. (1971). Death Drive, Ambivalence, and Narcissism. Psychoanal. St. Child, 26: 25–78.
 Ellenberger, H. (1970). The Discovery of the Unconscious. New York: Basic Books.
 Fiebert, M. S. (1997). In and out of Freud's shadow: A chronology of Adler's relationship with Freud. Individual Psychology, 53(3), 241–269.
Freud, S. (1909). Analysis of a Phobia in a Five-Year-Old Boy. Standard Edition of the Works of Sigmund Freud, London: Hogarth Press, Vol. 10, pp. 3–149.
 King, R. & Shelley, C. (2008). Community Feeling and Social Interest: Adlerian Parallels, Synergy, and Differences with the Field of Community Psychology. Journal of Community and Applied Social Psychology, 18, 96–107.
 Manaster, G. J., Painter, G., Deutsch, D., & Overholt, B. J. (Eds.). (1977). Alfred Adler: As We Remember Him. Chicago: North American Society of Adlerian Psychology.
 Shelley, C. (Ed.). (1998). Contemporary Perspectives on Psychotherapy and Homosexualities. London: Free Association Books.
 Slavik, S. & King, R. (2007). Adlerian therapeutic strategy. The Canadian Journal of Adlerian Psychology, 37(1), 3–16.
 Gantschacher, H. (ARBOS 2007). Witness and Victim of the Apocalypse, chapter 13 page 12 and chapter 14 page 6.
 Orgler, H. (1996). Alfred Adler, 22 (1), pg. 67–68.

Further reading 
 Orgler, Hertha, Alfred Adler, International Journal of Social Psychiatry, V. 22 (1), 1976-Spring, p. 67
 Phyllis Bottome (1939). Alfred Adler: A Biography. G. P. Putnam's Sons. New York.
 Phyllis Bottome (1939). Alfred Adler: Apostle of Freedom. London: Faber and Faber. 3rd Ed. 1957.
 Carlson, J., Watts, R. E., & Maniacci, M. (2005). Adlerian Therapy: Theory and Practice. Washington, DC: American Psychological Association. .
 Dinkmeyer, D., Sr., & Dreikurs, R. (2000). Encouraging Children to Learn. Philadelphia: Brunner-Routledge. .
 Rudolf Dreikurs (1935): An Introduction to Individual Psychology. London: Kegan Paul, Trench Trubner & Co. Ltd. (new edition 1983: London & New York: Routledge), .
 Grey, L. (1998). Alfred Adler: The Forgotten Prophet: A Vision for the 21st Century. Westport, CT: Praeger. .
 Handlbauer, B. (1998). The Freud-Adler Controversy. Oxford, UK: Oneworld. .
 Hoffman, E. (1994). The Drive for Self: Alfred Adler and the Founding of Individual Psychology. New York: Addison-Wesley Co. .
 Lehrer, R. (1999). "Adler and Nietzsche". In: J. Golomb, W. Santaniello, and R. Lehrer. (Eds.). Nietzsche and Depth Psychology. (pp. 229–246). Albany, NY: State University of New York Press. .
 Mosak, H. H. & Di Pietro, R. (2005). Early Recollections: Interpretive Method and Application. New York: Routledge. .
 Oberst, U. E. and Stewart, A. E. (2003). Adlerian Psychotherapy: An Advanced Approach to Individual Psychology. New York: Brunner-Routledge. .
 Orgler, H. (1963). Alfred Adler: The Man and His Work: Triumph Over the Inferiority Complex. New York: Liveright.
 Orgler, H. (1996). Alfred Adler, 22 (1), pg. 67–68.
 Josef Rattner (1983): Alfred Adler: Life and Literature. Ungar Pub. Co. .
 Slavik, S. & Carlson, J. (Eds.). (2005). Readings in the Theory of Individual Psychology. New York: Routledge. .
 Manès Sperber (1974). Masks of Loneliness: Alfred Adler in Perspective. New York: Macmillan. .
 Stepansky, P. E. (1983). In Freud's Shadow: Adler in Context. Hillsdale, NJ: Analytic Press. .
 Watts, R. E. (2003). Adlerian, cognitive, and constructivist therapies: An integrative dialogue. New York: Springer. .
 Watts, R. E., & Carlson, J. (1999). Interventions and strategies in counseling and psychotherapy. New York: Accelerated Development/Routledge. .
 Way, Lewis (1950): Adler's Place in Psychology. London: Allen & Unwin.
 Way, Lewis (1956): Alfred Adler: An Introduction to his Psychology. London: Pelican.
 West, G. K. (1975). Kierkegaard and Adler. Tallahassee: Florida State University.

External links 

 
 International Association of Individual Psychology
 Psychology Articles 
 The Adlerian Society (UK) and the Institute for Individual Psychology
 The North American Society of Adlerian Psychology
 Institutul de Psihologie si Psihoterapie Adleriana Romania
 Centro de Estudios Adlerianos Uruguay
 Classical Adlerian Psychology according to Alfred Adlers Institutes in San Francisco and Northwestern Washington
 AdlerPedia
 Hong Kong Society of Adlerian Psychology
 New Concept Coaching & Training Institute
 

1870 births
1937 deaths
Adlerian psychology
19th-century Austrian Jews
Jewish scientists
Austrian ophthalmologists
Austrian people of Hungarian-Jewish descent
Austrian psychiatrists
Austrian psychologists
Jewish psychiatrists
People from Rudolfsheim-Fünfhaus
University of Vienna alumni
Fraternal birth order has been correlated with male sexual orientation, with a significant volume of research finding that the more older brothers a male has from the same mother, the greater the probability he will have a homosexual orientation. Ray Blanchard and Anthony Bogaert first identified the association in the 1990s and named it the fraternal birth order effect. Scientists have attributed the effect to a prenatal biological mechanism, since the association is only present in men with older biological brothers, and not present among men with older step-brothers and adoptive brothers. The mechanism is thought to be a maternal immune response to male fetuses, whereby antibodies neutralize male Y-proteins thought to play a role in sexual differentiation during development. This would leave some regions of the brain associated with sexual orientation in the 'female typical' arrangement – or attracted to men. Biochemical evidence for this hypothesis was identified in 2017, finding mothers with a gay son, particularly those with older brothers, had heightened levels of antibodies to the NLGN4Y Y-protein than mothers with heterosexual sons.

The effect becomes stronger with each additional male pregnancy, with odds of the next son being gay increasing by 38–48%. This does not mean that all or most sons will be gay after several male pregnancies, but rather, the odds of having a gay son increase from approximately 2% for the first born son, to 3% for the second, 5% for the third and so on. Two studies have estimated between 15% and 29% of gay men owe their sexual orientation to this effect, but noted that the number may be higher since prior miscarriages and terminations may have exposed their mothers to Y-linked antigens. It has generally been thought that this maternal response would not apply to first born gay sons and that they may owe their orientation to genes, prenatal hormones and other maternal immune responses which also influence brain development. However, the 2017 lab study found that mothers with no sons had antibodies to male cells, which may be caused by common early miscarriages, and thus induce the effect for a first live born son. A variety of evolutionary explanations for why the response persists have been offered by scientists.

The few studies which have not observed a correlation between gay men and birth order have generally been criticized for methodological errors and sampling methods. J. Michael Bailey has said that no plausible hypothesis other than a maternal immune response has been identified. The effect is sometimes referred to as the older brother effect.

Overview
The fraternal birth order effect has been described by one of its proponents as "the most consistent biodemographic correlate of sexual orientation in men". In 1958, it was reported that homosexual men tend to have a greater number of older siblings (i.e., a 'later/higher birth order') than comparable heterosexual men and in 1962, these findings were published in detail. In 1996, Ray Blanchard and Anthony Bogaert demonstrated that the later birth order of homosexual men was solely due to a number of older brothers and not older sisters. They also showed that each older brother increased the odds of homosexuality in a later-born brother by 33%. Later the same year, Blanchard and Bogaert demonstrated the older brother effect in the Kinsey Interview Data, a "very large and historically significant data base". In a study published in 1998, Blanchard called this phenomenon the fraternal birth order effect.

Research over the years has established several facts. First, homosexual men do tend to have a higher birth order than heterosexual men, and this higher birth order is attributed to homosexual men having greater number of older brothers. According to several studies, each older brother increases a male child's naturally occurring odds of having a homosexual orientation by 28–48%. However, the numbers of older sisters, younger brothers, and younger sisters have no effect on those odds. It has been estimated that approximately one in seven homosexual males owes their sexual orientation to the fraternal birth order effect. There seems to be no effect of birth order on sexual orientation in women.

Secondly, the fraternal birth order effect operates through a biological mechanism during prenatal life, not during childhood or adolescence. Direct evidence for this is the fact that the fraternal birth order effect has been found even in males not raised with their biological brothers, and biochemical evidence was found in a lab study in 2017. It has been determined that biological brothers increase the odds of homosexuality in later-born males even if they were reared in different households, whereas non-biological siblings, such as step-brothers or adopted brothers, have no effect on male sexual orientation.
Indirect evidence also indicates that the fraternal birth order effect is prenatal and biological in nature rather than postnatal and psychosocial: The fraternal birth order effect has been confirmed to interact with handedness, as the incidence of homosexuality correlated with an increase in older brothers is seen only in right-handed males. Since handedness develops prenatally, this finding indicates that prenatal mechanisms underlie the fraternal birth order effect. It has also been found that homosexual males with older brothers have significantly lower birth weights compared to heterosexual males with older brothers. As birth weight is undeniably prenatally determined, it is known that a common developmental factor that operates before birth necessarily underlies the fraternal birth order effect and male sexual orientation.

Thirdly, the fraternal birth order effect has been demonstrated in diverse samples such as homosexual males from different ethnicities, different cultures, different historical eras, and widely separated geographic regions. The fraternal birth order effect has been demonstrated in places such as Brazil, Canada, Finland, Iran, Italy, The Netherlands, Samoa, Spain, Turkey, the United Kingdom, and the United States. The effect has also been demonstrated in homosexual men from convenience and representative, national probability samples.

In a 2017 study, researchers found an association between a maternal immune response to neuroligin 4 Y-linked protein (NLGN4Y) and subsequent sexual orientation in their sons. NLGN4Y is important in male brain development; the maternal immune reaction to it, in the form of anti-NLGN4Y antibodies, is thought to alter the brain structures underlying sexual orientation in the male fetus. The study found that women had significantly higher anti-NLGN4Y levels than men. The result also indicates that mothers of gay sons, particularly those with older brothers, had significantly higher anti-NLGN4Y levels than did the control samples of women, including mothers of heterosexual sons.

Empirical findings

Biodemographics
The fraternal birth order effect is a phenomenon that can be described in one of two ways: Older brothers increase the odds of homosexuality in later-born males or, alternatively, homosexual men tend to have more older brothers than do heterosexual men. It has been found that the proportion of older brothers (i.e., ) is 31% greater in the sibships of homosexual males than in the sibships of heterosexual males. Alternatively, the ratio of older brothers to other siblings (i.e., ) is 47% greater for homosexual males than it is for heterosexual males.

After statistically controlling for number of older brothers, homosexual and heterosexual males do not differ in their mean number of older sisters, younger sisters or younger brothers. Older sisters, younger sisters, and younger brothers have no effect on the odds of homosexuality in later born males – they neither enhance nor counteract the fraternal birth order effect. Blanchard and Bogaert (1996) investigated whether homosexual men have a higher mean birth order than heterosexual men primarily because they have more older brothers or because they have more older siblings of both sexes (i.e., both older brothers and older sisters). They confirmed that homosexuality was positively correlated with a man's number of older brothers, not older sisters, younger sisters, or younger brothers. Multiple studies have since confirmed this finding.

In a few studies, homosexual subjects have occasionally displayed both a larger number of older brothers and a larger number of older sisters in comparison to heterosexual men. This is because a person's number of older brothers and number of older sisters tend to be positively correlated. So, if Proband A has more older brothers than Proband B, chances are that Proband A also has more older sisters than Proband B. These findings of excess of older sisters are hence occasional by-products of homosexual men having an excess of older brothers, are not found as consistently as the excess of older brothers, and thus need not detract from the significance of the fraternal birth order effect. When samples are drawn from populations with relatively high fertility rates, the positive correlation between number of older brothers and older sisters may give the false impression that both the number of older brothers and the number of older sisters are associated with male sexual orientation. Indeed, two samples from the high fertility Samoan population displayed simultaneous fraternal and 'sororal' birth order effects. However, direct comparison of the magnitudes of these two effects showed that the fraternal birth order effect took precedence in the studies. Various studies and meta-analyses have confirmed that only the older brother effect is consistently associated with homosexuality:

 A 1998 meta-analysis by Jones and Blanchard investigated whether older sisters have no effect on sexual orientation in later-born males, or simply a weaker effect than older brothers. To this end, they developed competing mathematical models of the two possibilities: they derived two theoretical equations; the first equation applies if sisters have no direct relation to a proband's sexual orientation but brothers do; the second applies if sisters have the same relation to a proband's sexual orientation as do brothers (including no relation). They then compared the fit of these models to the empirical data available at that time and found that the first equation held for homosexual men and the second for heterosexual men. They also concluded that any tendency for homosexual males to be born later among their sisters is, in effect, a statistical artifact of their tendency to be born later among their brothers.
 A 2004 meta-analysis involved 10,143 male subjects of which 3181 were homosexual and 6962 were heterosexual. Its results reinforced the conclusion that homosexual men tend to have more older brothers than do heterosexual men, and the conclusion that differences in all other sibship parameters (older sisters, younger sisters, or younger brothers) are secondary consequences of the difference in older brothers. The same conclusions have been reached with analyses of individual rather than aggregate data, and by independent investigators.
 A 2015 meta-analysis determined that only the older brother effect/fraternal birth order effect was reliably associated with male sexual orientation across previously published studies.

The fraternal birth order effect is independent of potential confounding factors such as age, year of birth, and socioeconomic status. It has also been found that the fraternal birth order effect can be demonstrated whether the homosexual and heterosexual groups being compared on older brothers both have large or small family sizes, so long as both groups have the same family size (or can be adjusted to simulate that condition). Additionally, to detect the fraternal birth order effect, it is necessary that family size of homosexual and heterosexual groups are not strongly affected by the various parental strategies (so-called 'stopping rules') of ceasing reproduction after one child, after one male child, or after a child of each sex, because in these particular situations, neither homosexual nor heterosexual males have enough older brothers to make comparisons meaningful. For example, a study done in mainland China did not find any fraternal birth order effect, which the authors attributed to the one-child policy.

The relation between number of older brothers and male homosexuality is not an artifact of higher maternal or paternal age at the time of the proband's birth. This implies that the birth order phenomenon cannot be explained by increased mutation rates in the ova or sperm cells of aging mothers or fathers, respectively.

The relation between number of older brothers and male homosexuality is also not an artifact of birth interval. Blanchard and Bogaert (1997) conducted a study to investigate whether homosexual men are, on average, born a shorter time after their next-older siblings than are heterosexual men. They found that mean birth intervals preceding heterosexual and homosexual males were virtually identical.

No type of sibling (i.e., older brothers, older sisters, younger brothers or younger sisters) is reliably related to women's sexual orientation.

Quantitative findings
Research on the fraternal birth order effect has shown that for every older brother a male child has, there is a 33% increase in the naturally occurring odds that the male child being homosexual. The naturally occurring odds of a male child (without any older brothers) being homosexual are estimated to be 2%. Thus, if a male with no older brothers has a 2% chance of being homosexual and the fraternal birth order effect increases those chances by 33% for each older brother, then a male with one older brother has a 2.6% chance of being homosexual; a male with two older brothers has a 3.5% chance, and males with three and four older brothers have a 4.6%, and 6.0% chance, respectively.

Estimates of the proportion of homosexual men who owe their sexual orientation to the fraternal birth order effect have ranged from 15.1% to 28.6%. Cantor et al. (2002) found that 0% of homosexual men with no older brothers, 24% of homosexual men with one older brother, 43% of homosexual men with two older brothers, and so on, can attribute their homosexual orientation to the fraternal birth order effect. They also showed that the effect of fraternal birth order would exceed all other causes of homosexuality combined in groups of gay men with 3 or more older brothers and would precisely equal all other causes combined in a theoretical group with 2.5 older brothers. Homosexual men who did not acquire their sexual orientation via the fraternal birth order effect (for example, homosexual men with no older brothers) owe their homosexuality to other causes such as certain polymorphic genes (colloquially called "gay genes") or prenatal hormone levels during fetal development.

Timing of the fraternal birth order mechanism
Both direct and indirect evidence have demonstrated that the mechanism by which the fraternal birth order effect operates is prenatal in timing and biological in nature, rather than postnatal in timing or psychosocial in nature. Indirect evidence was found first when it was discovered that the fraternal birth order effect interacts with birth weight. Then, Bogaert (2006) produced direct evidence that the fraternal birth order mechanism is prenatal. Subsequent research related to handedness has further reinforced these findings. Evidence that the fraternal birth order effect reflects events during prenatal life is generally consistent with a lack of evidence that it reflects events during postnatal life.

Birth weight

The finding that the fraternal birth order mechanism operates during a male's prenatal development in the mother's womb arose unexpectedly, in a study of sexual orientation, birth order, and birth weight. Blanchard and Ellis (2001) studied 3229 adult, homosexual and heterosexual, men and women (the probands) whose mothers knew the sex of every child (or fetus) that they were pregnant with prior to the proband. Information on birth weight, maternal gravidity, and other demographic variables was reported on questionnaires completed by the probands' mothers. The study yielded three main observations:
 The heterosexual males with older brothers weighed less at birth than the heterosexual males with older sisters;
 The homosexual males with older brothers weighed less than the heterosexual males with older brothers, and: 
 The homosexual and heterosexual males with no older siblings, or older sisters only, did not differ in birth weight.
Each of these three findings has since been replicated in other studies (and the general finding that boys with older brothers have smaller birth weights than boys with older sisters is in line with earlier studies). These findings suggest that prior male pregnancies influence the development of subsequent male fetuses; that this influence is felt to varying degrees by individual fetuses; and that those fetuses who are most strongly affected by this process, as indicated by their comparatively lower birth weights, are also those most likely to be homosexual. The interaction of fraternal birth order with birth weight (an obviously prenatally determined trait) suggests that the mechanism of the fraternal birth order effect operates before the individual's birth (i.e., in utero). It also shows that, even at the time of birth, there is a physical marker of sexual orientation (i.e., birth weight) that is related to the number of older brothers.

Handedness

Blanchard et al. (2006) produced indirect evidence that the fraternal birth order effect is biological rather than psychosocial in nature: They found, in a sample of 3146 men, that the fraternal birth order effect was contingent on handedness: The effect of older brothers on the likelihood of homosexuality only occurred in right-handed males; the effect of older brothers did not alter the likelihood of being gay in left-handed and ambidextrous men. Later, another study found the fraternal birth order effect may be limited to only moderately right-handed men, as extreme right-handers also did not display a fraternal birth order effect. The finding that fraternal birth order interacts with handedness has been confirmed by subsequent research. As handedness is developed during prenatal life, this suggests that a prenatal mechanism causes increased homosexuality in right-handed male fetuses with older brothers.

Mechanism
In a 2017 study, researchers found an association between a maternal immune response to neuroligin 4 Y-linked protein (NLGN4Y) and subsequent sexual orientation in their sons. NLGN4Y is important in male brain development; maternal immune reaction to it, in the form of anti-NLGN4Y antibodies, is thought to alter the brain structures underlying sexual orientation in the male fetus. The study found that women had significantly higher anti-NLGN4Y levels than men. The result also indicates that mothers of gay sons, particularly those with older brothers, had significantly higher anti-NLGN4Y levels than did the control samples of women, including mothers of heterosexual sons.

Biological vs. non-biological older brothers
Bogaert (2006) provided a direct test pitting prenatal against postnatal (e.g., social/rearing) mechanisms and sought to determine which of the two account for the fraternal birth order effect. He examined the association between male sexual orientation and biological siblings (i.e., born from the same mother) and non-biological siblings (i.e., adoptive siblings, step-siblings or paternal half-siblings). Whether and how long participants were reared with these siblings was also examined.

If rearing or social factors associated with older brothers underlie the fraternal birth order effect, then all older brothers (both biological and non-biological) reared with the participant should predict sexual orientation because all of these older brothers share the social/rearing environment with their younger brothers. If a prenatal factor underlies the fraternal birth order effect, then only biological older brothers should predict sexual orientation because only biological older brothers share prenatal characteristics (e.g., gestation by the same biological mother) with their younger brothers. The study found that only biological older brothers predicted sexual orientation. Even when the number of non-biological older brothers significantly exceeded the number of biological older brothers, and hence the opportunity for an effect via being reared with (non-biological) older brothers was high, only the number of biological older brothers and not non-biological older brothers predicted sexual orientation in men.

Further, if rearing or social factors underlie the fraternal birth order effect, then the amount of time reared with older brothers, either biological or non-biological, should predict sexual orientation because rearing time determines the relative opportunity that older brothers have to affect their younger sibling's (postnatal) sociosexual development. If a prenatal factor underlies the fraternal birth order effect, then a postnatal factor such as rearing time with older siblings (be they biological or non-biological) should have no impact on the sexual orientation of younger male siblings. The study found that the amount of time reared with older brothers, either biological or non-biological, neither predicted sexual orientation nor affected the relationship between older brothers and sexual orientation, thereby pointing to a prenatal origin of the fraternal birth order effect.

Finally, if rearing or social factors underlie the fraternal birth order effect, then the number of biological older brothers with whom the participants were not reared should not predict sexual orientation because they should have no impact on the (postnatal) sociosexual environment of their younger brothers. If a prenatal factor underlies the fraternal birth order effect, then biological older brothers with whom the participants were not reared should still predict sexual orientation because all biological older brothers, even those not reared with the participants, share prenatal characteristics (e.g., gestation by the same mother) with their younger brothers. The study found that the number of biological brothers does predict men's sexual orientation even if the participants were not reared with the biological older brothers.

In summation, it was found that biological older brothers significantly predicted male sexual orientation regardless of whether or how long participants were reared with these brothers whereas the remaining sibling categories, including non-biological older brothers, did not. These results thus support a prenatal origin to sexual orientation development in men and indicate that the fraternal birth order effect is probably the result of the mother's body's "memory" for both male births as well as male gestations (i.e., every instance of being pregnant with a male fetus). So even if a male fetus was not carried to term, he still increases the likelihood of homosexuality in any subsequent male fetuses gestated by the same mother.

Ubiquity
The existence of the fraternal birth order effect on male sexual orientation has been confirmed many times. One approach for establishing the ubiquity of this effect has been to search for it in a variety of sample types. The repeated finding of the fraternal birth order effect in diverse samples shows that the effect is nearly ubiquitous – with the exception of populations where people do not have older brothers.

The fraternal birth order effect has been found in homosexual males from different races, including White, Black, Hispanic, East Indian, Asian, Middle Eastern and Polynesian. The effect has also been found in homosexual males from different historical eras, ranging from participants examined in recent years to participants examined decades ago.

The effect has also been demonstrated in homosexual males from different cultures: Despite how variable cultures can be, cross-cultural universals in the development of homosexual males appear to exist. For example, in Western cultures, homosexual males exhibit comparatively more gender-nonconforming behavior during childhood than heterosexual males. Retrospective studies conducted in Brazil, Guatemala, Independent Samoa, the Philippines, Thailand, and Turkey have found that the same is true of homosexual males raised in these non-Western cultures. Such cross-cultural similarities in childhood behavior support the idea that similar biological influences, which transcend cultural differences, play a role in the development of male homosexuality. This idea would be further supported if it could be demonstrated that causal biological factors, such as the fraternal birth order mechanism (which is biological in nature), are likely to influence the development of male homosexuality in non-Western cultures. Thus, establishing the existence of the fraternal birth order effect — a hypothesized outcome of the fraternal birth order mechanism — in a non-Western culture would further substantiate arguments that similar biological influences underlie the development of homosexuality across cultures. Studies in Western as well as non-Western cultures have demonstrated fraternal birth order effect (as well as fecundity effects) in relation to male homosexuality. The cross-cultural consistency with which these effects have been documented is consistent with the conclusion that culturally invariant, biological processes underlie the development of homosexuality in males.

The fraternal birth order effect has also been demonstrated in widely separated geographic regions and in countries such as Brazil, Canada, Finland, Iran, Italy, The Netherlands, Independent Samoa, Spain,
Turkey, the United Kingdom, and the United States. The effect has additionally been observed in participants examined during childhood as well as adulthood and in patients as well as in non-patient volunteers. The fraternal birth order effect has been demonstrated by Blanchard and colleagues as well as by independent researchers. The demonstration of the fraternal birth order effect in meta-analysis of studies by Blanchard and colleagues, meta-analysis of studies by independent investigators and studies by both Blanchard and other investigators shows that studies of the fraternal birth order effect have been free from experimenter bias. The effect has also been demonstrated in homosexual men from convenience samples and in representative, national probability samples.

Most research on the fraternal birth order effect has been carried out on gay men. However, the fraternal birth order effect has been observed in androphilic transgender women (who were assigned male at birth). Trans women who are exclusively sexually oriented towards men have a greater number of older brothers than trans women who are sexually interested in women. This has been reported in samples from Canada, the United Kingdom, the Netherlands, and Polynesia.

Three studies have investigated whether sexual orientation also correlates with fraternal birth order in men attracted to physically immature males. One study (Bogaert et al., 1997) found that homosexual-bisexual male pedophiles had a later general birth order than heterosexual male pedophiles and this late birth order was primarily due to the homosexual-bisexual group being born later among their brothers than later among their sisters. Another study (Blanchard and Bogaert, 1998) did not confirm a later fraternal birth order for men with sexual offenses against prepubescent boys or girls, but did confirm it for men with offenses against pubescent boys or girls. The inconsistency of these findings regarding the correlation of sexual orientation and fraternal birth order in pedophiles may be related to methodological problems in the two studies. The first study was a retrospective study of sex offenders, which included only those subjects whose clinical charts happened to contain birth order data so the results of the study may have been affected by selection bias. The second study was a reanalysis of archived data from a classic study of sexual offenders from the year 1965. There was minimal recoverable information regarding the subjects' offense histories, and there is a possibility that the sexual preferences of the pedophiles in the study were not accurately classified from the available information.

Blanchard et al. (2000) therefore conducted a study in which data were collected with the specific purpose of examining the relation of fraternal birth order to sexual orientation in homosexual, bisexual and heterosexual pedophiles. Each type of pedophilic group was compared with a control group that consisted of gynephilic men (i.e., men attracted to adult females). The study found that homosexual pedophiles had more older brothers than the gynephilic control group while the bisexual and heterosexual pedophiles did not. These results confirm that fraternal birth order correlates with sexual orientation in pedophiles, as it does in teleiophiles (i.e., people exclusively attracted to adults). The results also confirm that fraternal birth order does not correlate with pedophilia per se: Previous studies had established that the fraternal birth order effect affects what gender a man is sexually attracted to; Blanchard et al. (2000) additionally investigated if fraternal birth order also affects the age of persons to whom a man is attracted. Results from the study indicate that fraternal birth order does not affect the age of preferred erotic targets and that fraternal birth order does not correlate with pedophilia. So the fraternal birth order mechanism only causes males to be attracted to other males; whatever mechanism causes males to be pedophilic as opposed to teleiophilic (i.e., attracted to adults) is different from the fraternal birth order mechanism itself.

Other than fraternal birth order, no common feature has been identified in the developmental histories or family demographics of androphiles and pedophiles, while key features distinguish the two groups, for example, most androphilic males display gender non-conformity during childhood whereas same-sex attracted pedophiles do not. To prevent misunderstanding or misuse of their studies on fraternal birth order in pedophiles, researchers have stressed that any conclusion that homosexual pedophilia shares an etiological factor with androphilia does not imply that ordinary homosexual men (androphiles) are likely to molest boys, any more than the conclusion that heterosexual pedophilia shares an etiological factor with gynephilia would imply that ordinary heterosexual men (gynephiles) are likely to molest girls.

The finding of the fraternal birth order effect in cisgender and transgender male androphiles, men attracted to boys and those attracted to adult men—same-sex attracted groups who differ as widely as possible in their own characteristics and in the characteristics of their desired partners—would suggest that fraternal birth order (or the underlying variable it reflects) may be the first universal factor to be identified in development of same-sex attraction in males.

Other findings
Bearman and Brückner (2002) argued that studies showing a fraternal birth order effect have used nonrepresentative samples and/or indirect reports on siblings' sexual orientation.  Their analysis, focusing on opposite-sex twins, did not find an association "between same-sex attraction and number of older siblings, older brothers, or older sisters". A study by Francis (2008), using the same Add Health survey but with broader analysis, saw a very weak correlation of male same-sex attraction with having multiple older brothers (but did find a significant negative correlation of male same-sex attraction with having older sisters i.e., those who experienced a non-zero level of same-sex attraction were significantly less likely to have older sisters).

The failure of these studies to demonstrate the fraternal birth order effect has been attributed to their methodological flaws. Although they utilized large adolescent samples, the low base rates of same-sex attraction and behaviour in the population resulted in sample sizes that were too small for assessing the relation of birth order to sexual orientation. The fraternal birth order effect may also have been obscured in these studies due to their use of different methods of sexual orientation classification and their imprecise measures of sibships. Ray Blanchard explained that the demonstrability of the fraternal birth order effect depends partly on the adequate matching of the mean family size of the homosexual and heterosexual study groups and noted that in the two studies above, the mean family size of the homosexual groups was significantly smaller than that of the heterosexual comparison groups. Specifically, heterosexual males had larger numbers of siblings overall than the homosexual males which may have obscured the analyses of group differences in older brothers and  prevented the demonstration of the fraternal birth order effect. Researchers have thus emphasized the necessity of comparing groups on measures of mean family size and have suggested that, in the two studies, an alternative birth order metric that controlled for sibship size would have produced findings consistent with the fraternal birth order effect. Since the publication of Bearman and Bruckner's study in 2002, studies that used representative national probability samples and direct reports on siblings' sexual orientation have found the fraternal birth order effect.

Currin et al. (2015) carried out a study investigating the existence of the fraternal birth order effect in a variety of sexual orientation dimensions – namely, identity, attraction, fantasies, and behavior – whereas previous research studied only one such dimension (identity). Participants in the study were split into two groups: a "heterosexual group" and a "non-heterosexual" group. To determine what label participants used to identify their sexual orientation, participants were asked, "How would you classify your sexual orientation?" and selected from one of five options (heterosexual, mostly heterosexual, bisexual, mostly gay/lesbian, gay/lesbian). People who selected "heterosexual" were place in the heterosexual group, whereas people selecting "gay/lesbian" were placed in the non-heterosexual group. To assess sexual attraction, participants were asked, "How sexually attracted are you to men?" and selected from a 7-point Likert scale ranging from 1 (not at all) to 7 (very much). Participants were also asked "How sexually attracted are you to women?" and were presented with the same Likert scale. People who selected 1 (not at all) when answering the same sex sexual attraction question were placed in the heterosexual group. People who selected 2 or greater were placed in the non-heterosexual group.

To assess sexual behavior, participants were asked, "What is the total number of male sexual partners you have had?" and "What is the total number of female sexual partners you have had?" Sexual partner was defined as someone with whom the participant had penile–vaginal penetration, oral sex, anal sex, and/or mutual masturbation. Individuals who identified having any same-sex sexual partner (i.e., 1 or more) were placed in the non-heterosexual group while individuals who did not identify having a same-sex sexual partner were placed in the heterosexual group. To assess sexual fantasy, participants were asked "What percent of your sexual fantasies during masturbation involve men?" and rated the question from 0% to 100%. Each participant was also asked "What percent of your sexual fantasies during masturbation involve women?" and rated the question from 0% to 100%. If an individual endorsed having any same-sex sexual fantasies at all (i.e., 1% or greater), they were placed in the non-heterosexual group, otherwise they were placed in the heterosexual group. Using these criteria for sexual orientation identity, attraction, fantasies, and behavior, Currin et al. (2015) were unable to demonstrate the effect for any dimensions in their sample of 722 right-handed men (of which 500 were classified as heterosexual and 122 were classified as non-heterosexual), although the study did adjust for family size differences between the two groups. A 2017 meta-analysis analyzed studies about the fraternal birth order effect including Currin et al. (2015). The meta-analysis had a total sample of 7140 homosexual males and 12,837 heterosexual males. The results of the meta-analysis confirmed the reliability of the fraternal birth order effect.

Frisch et al. (2006) did not find a correlation between older brothers and same-sex unions between men in a sample of over 2 million Danes. Instead, researchers found a correlation between such unions and having an excess of older sisters. Frisch cautioned that one cannot interpret findings about the correlates of heterosexual and homosexual marriage as if they were findings about the correlates of heterosexual and homosexual orientation. Ray Blanchard performed a reanalysis of Frisch's data using procedures that have been used in prior studies of fraternal birth order. According to his analysis, "the only group whose data resembled data from previous studies was the homosexually married males", reaffirming the birth order effect. He further criticized drawing conclusions from data of married persons, since heterosexually married persons also have "markedly different older-sibling sex ratios" than heterosexually oriented persons.

Theories about the fraternal birth order mechanism

Anthony Bogaert's work involving adoptees concludes that the effect is not due to being raised with older brothers, but is hypothesized to have something to do with changes induced in the mother's body when gestating a boy that affects subsequent sons. This is because the effect is present regardless of whether or not the older brothers are raised in the same family environment with the boy. There is no effect when the number of older brothers is increased by adopted brothers or stepbrothers.  It has been hypothesized that this is caused by an in-utero maternal alloimmune response, specifically, the mother's immune system becoming sensitized to H-Y antigens involved in the sexual differentiation of male vertebrates, and producing antibodies that attack these antigens. Specifically, maternal antigens to the neuroligin NLGN4Y protein, Y-chromosone protein important in male fetal brain development, have been found to be involved in the fraternal birth order effect.

See also
Biology and sexual orientation
Birth order
Handedness and sexual orientation
H-Y antigen
Prenatal hormones and sexual orientation

Notes

References

Human development
Sexual orientation
Sibling Absolutely, Positively Not, also known as Absolutely, Positively Not Gay is the first book by author David LaRochelle. The book centers on a 16-year-old homosexual boy, who struggles with his sexual feelings.

Plot summary 
Steven DeNarsky, a 16-year-old Superman fan, starts to develop sexual feelings for his substitute homeroom teacher, Mr. Bowman. Steven tries to reassure himself by buying such magazines like Playboy and the Victoria's Secret catalog, and dating several attractive girls. Unable to bottle his emotions any longer, he confesses to his friend, Rachel, that he is gay. To his surprise, Rachel and her entire family had previously assumed that Steven was gay, and already waited for him to tell her. Rachel urges Steven to create a gay/lesbian alliance club at their high school, but Steven is not optimistic about completely "coming out of the closet". Steven later does reveal that he is gay to both his parents, who don't think much of it. Steven eventually accepts his homosexuality by attending a teen gay/lesbian club, but mistakenly goes when it is specifically a lesbian meeting. Despite this, he has a good time and decides to embrace his homosexuality.

Reception 
The novel was well received by Booklist Review and School Library Journal.

References

External links 
 Scholastic Profile
 IBlist Profile
 Barnes and Noble Profile

2005 American novels
American young adult novels
American LGBT novels
2000s LGBT novels
LGBT-related young adult novels
2005 debut novels